Aim To identify clinical and laboratory indexes related with the atherosclerotic plaque (ASP) echogenicity based on results of the analysis of grey-scale median (GSM) in patients aged 40–64 years.Material and methods The study included patients aged 40–64 years with carotid atherosclerosis. The carotid duplex scanning was performed for all patients. The GSM analysis of obtained images was performed with the Adobe Photoshop CS6 software.Results Atherosclerotic cardiovascular diseases were found in 31 (21.4 %) patients. Correlation analysis determined inverse interrelationships between GSM and the body weight index (BWI) (r=–0.359; p<0.0001), waist circumference (r=–0.357; p<0.0001), and levels of uric acid (r=–0.244; p=0.021) and glucose (r=–0.205; p=0.032). According to the regression, statistically significant correlations remained between GSM and BWI as well as the waist circumference after the adjustment for sex and age.Conclusion In patients with carotid atherosclerosis aged 40–64 years, the decrease in ASP GSM was associated with increases in BWI and waist circumference.